Talar Fractures and Dislocations

2016 ◽  
pp. 59-102
Keyword(s):  
Talar Fractures

scholarly journals Closed Pan-talar Dislocation with Posterior Talar Process Fracture

2015 ◽  
Vol 1 (2) ◽  
pp. 32-35
Author(s):  
M Pramod Kumar ◽  
KM Gopinath ◽  
BN Roshan Kumar ◽  
GA Gautham Balaji
Keyword(s):  
Closed Reduction ◽  
Reduction Process ◽  
Road Accident ◽  
Review Of Literature ◽  
Open Injury ◽  
Accident Victim ◽  
Talar Fractures ◽  
The Right ◽  
Steinmann Pin

ABSTRACT Total dislocation of the talus has been reported as 0.06% of all dislocations and 2% of all talar fractures. It usually occurs from considerable violence. Total dislocation of the talus is frequently an open injury, or the skin may be tented over the dislocated talus leading to skin slough. Closed total dislocation of talus with posterior process injury is rare. The functional prognosis is poor due to osteonecrosis of the talus which develops in the majority of cases. Review of literature reported successful closed reduction in cases of closed pan-talar dislocation under anesthesia. However, there were few cases where there was difficulty in closed reduction. Operative technique has also been described in different reports of similar cases. Case report We present a case of pan-talar dislocation of the left talus in a 25-year-old road accident victim, with posterior talar process fracture. Reduction of dislocation was attempted in emergency department by external manipulation. Reduction process failed, and hence planned for reduction under anesthesia. It required a open reduction after a unsuccessful closed reduction attempt. The talus after reduction was found to be unstable hence, stabilized with trans-calcaneotalar Steinmann pin. At 1-year follow-up, the right ankle was pain free and stable. Motion was satisfactory. The talus after a follow-up of 1 year did not show any signs of subluxation or avascular necrosis. Conclusion The main obstacle to closed reduction appeared to be talus had button holed through dorsal fascia. The talus after reduction was found to be unstable hence stabilized with trans-calcaneotalar Steinmann pin. The management of the associated fracture will depend on many factors, particularly displacement of the fracture fragments. How to cite this article Kumar MP, Gopinath KM, Kumar BNR, Balaji GAG. Closed Pan-talar Dislocation with Posterior Talar Process Fracture. J Med Sci 2015;1(2):32-35.

scholarly journals Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

2018 ◽  
Vol 12 (1) ◽  
pp. 567-575
Author(s):  
D. Leonetti ◽  
B. Di Matteo ◽  
P. Barca ◽  
S. Cialdella ◽  
F. Traina ◽  
...  
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Clinical Results ◽  
Fracture Dislocation ◽  
Review Of Literature ◽  
Non Union ◽  
Fracture Dislocations ◽  
Neck Fracture ◽  
Talar Fractures

Introduction: Talar fractures are uncommon injuries, whose outcome is often characterized by the onset of serious complications. The aims of the present study are: 1) to review the available evidence concerning the outcome and complications of talar neck fractures; 2) to describe the clinical results and the rate of post-op complications in a series of patients treated surgically after talar fracture-dislocations. Materials and methods: The review of the literature was performed on the Pubmed, Embase and Web of Science databases and aimed at identifying clinical trials with at least 10 patients and dealing with surgical management of talar fracture-dislocation (Hawkins grade II to IV). All the papers were analyzed to extract data concerning common complications such as non-union, mal-union, infection, osteonecrosis and osteoarthtritis. The clinical arm of this paper included 26 patients (19 men and 7 women), who underwent fixation of displaced talar fracture by cannulated screws and were retrospectively evaluated, both clinically and radiographically, at a mean 51.2 ± 23.4 months of follow-up. Results: The evaluation through the AOFAS score revelead a loss of functional performance with respect to the pre-injury status. Four patients were re-operated within final follow up, whereas the remaining 22 presented excellent results in 2 cases, good results in 4 cases, fair results in 11 cases and poor results in 5 cases. Osteoarthritis and osteonecrosis incidence were 51.9% and 25.9% respectively. Sixteen studies were included in the review and it was confirmed that the most frequent complication was post-traumatic OA, followed by osteonecrosis and mal-union. A variable range in percentage of complications described should be ascribed to the low quality of trials currently available. Conclusion: Displaced talar fracture are challenging to treat and the outcomes at middle-term are often modest. Looking at complications, the present case series and the review of literature revealed that the most common one is peritalar OA. Osteonecrosis, traditionally regarded as the most fearsome adverse event, is relevant but less frequent than OA.

Ipsilateral Fractures of the Talus and Calcaneus

1996 ◽  
Vol 17 (11) ◽  
pp. 701-705 ◽  
Author(s):  
Paul Gregory ◽  
Thomas DiPasquale ◽  
Dolfi Herscovici ◽  
Roy Sanders
Keyword(s):  
Standard Treatment ◽  
Talus Fracture ◽  
Treatment Regimens ◽  
Combined Injury ◽  
Joint Surfaces ◽  
Articular Damage ◽  
Talar Fractures ◽  
Level I ◽  
Both Bones

Nine ipsilateral fractures of the talus and calcaneus were treated at Tampa General Hospital between 1991 and 1994 and entered into the trauma registry of this level I trauma center. During this same period, a total of 78 talar fractures and 334 calcaneal fractures were entered into the registry. The patients who sustained this rare combined injury were studied retrospectively to characterize the fractures that occurred, examine the treatments instituted, and determine outcomes. Four patients had severe intra-articular damage of the subtalar joint surfaces and underwent either primary or delayed arthrodesis. This subgroup of patients was followed for an average of 39 months (range, 25–45 months), and all had excellent or good outcome as assessed by the Maryland Foot Score. Three patients had nondisplaced or avulsion-type fractures of both bones, which were treated with immobilization. These all healed well. One patient had a Hawkins type 2 talus fracture with an extra-articular avulsion fracture of the Achilles tendon. This patient did well with open reduction and internal fixation of both fractures. The final patient had a crushed lower extremity in association with her hindfoot injury, which resulted in primary below-knee amputation. In general, we believe each individual fracture in this combined injury can be addressed with standard treatment regimens.

Current Concepts Review: Talar Fractures

2006 ◽  
Vol 27 (6) ◽  
pp. 475-482 ◽  
Author(s):  
Jamal Ahmad ◽  
Steven M. Raikin
Keyword(s):  
Talar Fractures

scholarly journals Ceramic Artificial Talus as the Initial Treatment for Comminuted Talar Fractures

2019 ◽  
Vol 41 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Ryuhei Katsui ◽  
Yoshinori Takakura ◽  
Akira Taniguchi ◽  
Yasuhito Tanaka
Keyword(s):  
Range Of Motion ◽  
Initial Treatment ◽  
Weight Bearing ◽  
High Energy ◽  
Level Of Evidence ◽  
Custom Made ◽  
Sport Activities ◽  
Talar Fractures ◽  
American Orthopaedic ◽  
Retrospective Comparative Study

Background: Comminuted talar fractures are rare. Generally, this fracture occurs as a result of high-energy injuries. Therefore, this operation is challenging for the surgeon. We started to replace the whole talus with a total talar prosthesis in cases of aseptic talar necrosis in 2005. Based on these results, replacement with a ceramic artificial talus was performed as the initial treatment for comminuted talar fractures. Methods: From 2009 to 2016, a total of 6 feet of 6 patients with comminuted talar dome fractures or talar body defects were replaced with a ceramic artificial talus. The patients’ mean age was 40.3 years (range, 19-59). Postoperative assessments were performed in accordance with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot score system. Postoperative range of motion and sports activities were also evaluated. Follow-up ranged from 12 to 84 (mean, 46.8) months. Results: The postoperative AOFAS score was on average 78.8 (64-100). The postoperative range of motion was on average 10 degrees (5-20) for dorsiflexion and 31 degrees (15-50) for plantarflexion. Three patients had returned to sport activities. Conclusion: Prosthetic total talar replacement was a useful procedure for patients with comminuted talar fractures, which had good congruency of the custom-made implant with the adjacent joints, resulting in stability, and maintained ankle function. Furthermore, this procedure could prevent the complications of long-term external fixation and non-weight-bearing walking seen after open reduction and arthrodesis. Level of Evidence: Level IV, retrospective comparative study.

scholarly journals Aseptic (avascular) bone necrosis in the foot and ankle

2020 ◽  
Vol 5 (10) ◽  
pp. 684-690
Author(s):  
Xavier Martin Oliva ◽  
Antonio Viladot Voegeli
Keyword(s):  
Metatarsophalangeal Joint ◽  
Growth Period ◽  
Common Denominator ◽  
Loose Bodies ◽  
Disease Treatment ◽  
Aseptic Necrosis ◽  
Bone Necrosis ◽  
Tarsal Bones ◽  
Advanced Stages ◽  
Talar Fractures

Aseptic necrosis may be defined as a group of diseases that have bone necrosis as a common denominator. They usually appear in the epiphyses and in the carpal and tarsal bones. They generally appear during a growth period and principally at those skeletal points subjected to particular stress. In Müller–Weiss disease in the advanced stages, talonavicular-cuneiform arthrodesis, with or without back foot correction, is the best surgical option. In Freiberg–Kohler disease, treatment can be conservative and we can maintain the head of the metatarsal by performing a joint debridement of the metatarsophalangeal joint with removal of loose bodies. The lateral upper and lower faces of the distal extremity of the metatarsal are resected, preserving the joint cartilage that in its centre portion is always healthy. The osteophyte border that may be present in the phalanx is resected. Most frequently, avascular necrosis (AVN) of the talus is a sequel to talar fractures, with the possibility that the AVN increases with the severity of the trauma and the damage associated with the already precarious blood supply of the talus. The surgical treatment used for sesamoid AVN is partial excision of the affected bone. Cite this article: EFORT Open Rev 2020;5:684-690. DOI: 10.1302/2058-5241.5.200007

Extra-articular Medial Impression Fracture of the Talus: A Previously Undescribed Injury

2018 ◽  
Vol 11 (6) ◽  
pp. 553-558
Author(s):  
Olivier Wijers ◽  
Rosa C. Looijen ◽  
Jens A. Halm ◽  
Tim Schepers
Keyword(s):  
Correct Diagnosis ◽  
Case Series ◽  
Patient Characteristics ◽  
Trauma Mechanism ◽  
Retrospective Case ◽  
Articular Fractures ◽  
First Case ◽  
Impression Fracture ◽  
Talar Fractures ◽  
Almost All

Background: Peripheral fractures of the talus are uncommon. Almost all the literature regarding talar fractures consists of central intra-articular fractures, whereas studies about peripheral talar fractures are lacking. The aim of this study is to increase awareness in diagnosing an unusual peripheral extra-articular medial impression fracture of the talus. Methods: This study includes a retrospective case series of patients with an extra-articular medial impression fracture of the talus. Patient characteristics, trauma mechanism, diagnostics, fracture characteristics, and treatment were reported. Results: Eight consecutive patients with an extra-articular medial impression fracture of the talus were identified. In 80%, the trauma mechanism was a supination or inversion injury of the ankle and foot. An X-ray was obtained in all patients; in 7 (88%) patients, a computed tomography scan was done, and an additional magnetic resonance imaging was done in 3 (38%) patients. In 4 patients (50%), the correct diagnosis was missed at first presentation. The delay between injury and diagnosis was 0 to 180 days (of 36 days on average). Conclusion: This is the first case series to describe patients with a peripheral extra-articular medial impression fracture of the talus. Good clinical examination and judicious use of diagnostic imaging are a necessity to find the talar impression fractures in a timely manner, and treatment can be started immediately. Levels of Evidence: Level V

Helical CT of talar fractures

1997 ◽  
Vol 26 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Richard J. Wechsler ◽  
Mark E. Schweitzer ◽  
David Karasick ◽  
Diane M. Deely ◽  
Jeffrey B. Glaser
Keyword(s):  
Helical Ct ◽  
Talar Fractures
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